Cardiac Mapping Apparatus Contact Quality CFAE Site Identification

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Solution Overview

Problem

Current methods for mapping complex fractionated atrial electrograms (CFAEs) in the heart often identify both active and passive sites, leading to unnecessary ablation and potential heart function impairment, as they fail to distinguish between localized and far-field signal sources effectively.

Innovation Solution

A mapping apparatus and software product that utilize contact quality measurements, such as contact force and angle, to differentiate between active and passive CFAE sites, ensuring only active sites are targeted for ablation by rejecting data points outside predetermined contact quality ranges.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If CFAE mapping is performed without contact quality measurement, then mapping coverage is achieved, but active and passive sites cannot be distinguished leading to unnecessary ablation

Engineering Contradiction:
ImproveCFAE site identification accuracyVSAvoidcollateral damage to heart function
Core Design Contradiction:
Measurement precisionVSObject-generated harmful factors

Solution Approach 1:

The patent introduces contact quality metrics as an intermediary parameter to distinguish between active and passive CFAE sites. By measuring contact force and contact angle as intermediate variables, the system can filter out passive sites (which typically have poor contact quality) while identifying active sites (which maintain consistent contact quality), thereby preventing unnecessary ablation of non-target tissue and reducing collateral damage to heart function.

Inventive Principle:
Principle #24Intermediary (Mediator)

2Measurement precision

If contact quality measurement is implemented, then active CFAE sites can be distinguished, but device complexity increases

Engineering Contradiction:
ImproveCFAE site differentiation accuracyVSAvoidmapping apparatus complexity
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The patent integrates multiple functions into the mapping apparatus: the catheter simultaneously performs electrical signal recording, contact force measurement, and contact angle determination. By combining these functions in a single integrated device, the system achieves precise CFAE site differentiation without proportionally increasing overall device complexity, as the additional sensing capabilities are incorporated into the existing catheter structure.

Inventive Principle:
Principle #6Universality (Multi-functionality)

Solution Approach 2:

The patent replaces complex mechanical contact assessment methods with sensor-based measurements. Instead of relying on operator judgment or complex mechanical indicators of contact quality, the system uses force sensors and angle sensors to objectively measure contact parameters, simplifying the overall system while improving measurement precision.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

3Reliability

If all identified CFAE sites are ablated, then treatment completeness is achieved, but procedural time and complications increase

Engineering Contradiction:
Improvetreatment effectivenessVSAvoidprocedural time
Core Design Contradiction:
ReliabilityVSLoss of time

Solution Approach 1:

The patent extracts and removes passive CFAE sites from the treatment target list by using contact quality metrics to identify and exclude them from ablation candidates. By taking out these non-essential sites (which typically show poor or variable contact quality) from the ablation protocol, the system maintains treatment effectiveness for active sites while significantly reducing procedural time and minimizing complications associated with unnecessary ablation.

Inventive Principle:
Principle #2Taking out (Extraction)

Data Source

PatentEP2462867B1Identifying critical cfae sites using contact measurement
Publication Date: 2019.07.03 BIOSENSE WEBSTER (ISRAEL) LTD
  • EP2462867B1 patent drawingFigure 1
  • EP2462867B1 patent drawingFigure 2
  • EP2462867B1 patent drawingFigure 3A~3C

AI summary

A method for mapping includes receiving electrical inputs measured by a probe at respective locations in a chamber of a heart of a subject. The electrical inputs a r e processed to identify complex fractionated electrograms. At each of the respective locations, a respective contact quality between the probe and a tissue in the chamber is measured. A map of the complex fractionated electrograms in the chamber is created using the electrical inputs and the measured contact quality.